Alzheimer’s disease and dementia, which affect memory and other cognitive abilities, can create anger, anxiety, confusion and fear for a person living with the disease. It doesn’t help that explaining and reasoning with a person with dementia probably won’t ease their frustration.
An approach called “redirection,” however, frequently helps. Redirection is a technique in which you shift a distressed person’s attention away from the situation that is causing anger, anxiety, fear or dangerous or unsafe behavior to a more pleasant emotion or situation. Learn more about how to redirect a parent or senior loved one with dementia and why the technique works.
It’s happening again. Even though you’ve explained many times to Mom, who has dementia, that she can’t call her sister, Elaine, who’s been dead for five years, Mom insists on calling her right now.
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To make matters worse, she’s becoming agitated, even paranoid. “What have you done with Elaine? Why won’t you let me call her?” Mom asks. But what can you do to calm her?
When a person has dementia, he or she is unable to process information like they used to. That’s because dementia’s impairments aren’t restricted to memory loss. Those diseases also compromise the “executive functioning” capabilities of insight, judgment and reasoning.
As a result, your loved one with dementia can be incapable of telling the difference between a hallucination and reality – and trying to explain why that person’s perceived reality isn’t true is pointless. Such an explanation can escalate already strong emotions.
Heightened emotions in a person with Alzheimer’s or dementia typically emerge as what’s known as “behavioral expressions,” says Nancy Kriseman, author of “Meaningful Connections: Positive Ways to Be Together When a Loved One Has Dementia.” Kriseman is a geriatric clinical social worker and owner of Geriatric Consulting Services in Atlanta, Georgia.
“When your loved one with Alzheimer’s or dementia acts inappropriately, becomes anxious or engages in unsafe behavior, knowing how to interact with the person to shift that behavior is a valuable tool,” says Kriseman.
It’s possible to find ways to still stay connected to your loved one with dementia so they don’t feel that you’re trying to bully or push, which can backfire, says Kriseman. Instead, try to understand that your loved one’s anxiety, fear or other emotion probably stems from frustration or feeling out of control. For example, a person with dementia may ask the same question again and again because they have trouble processing the answer, says Kriseman. Maybe someone’s frustration stems from having difficulty trying to communicate what they need.
Fortunately, redirection can sometimes alleviate frustration for both the person with dementia and their family caregiver.
Here are Kriseman’s top seven tips on how to redirect a loved one with Alzheimer’s or dementia:
Is the room too hot or cold but your loved one can’t find the words to express that? Is the space calm and comforting or noisy? Sometimes, it’s the environment itself that needs redirection.
If Mom keeps pushing furniture against the door and insists that someone is trying to break in, explaining that no one is attempting to get in probably won’t ease her fear. Instead, Kriseman suggests responding to the emotions behind the actions.
“You don’t have to say, ‘I believe that this is happening’ but you can say ‘I’m so sorry this is happening to you,’” says Kriseman. “You might say, ‘Mom, I really want you to feel safe. How can I help you feel safe?’” In this scenario, you realize what is causing your loved one’s agitation and redirect her feelings from a place of insecurity to one of security because she feels like you finally believe her and are on her side.
Try to step outside for some fresh air and a change of environment if you can,” says Kriseman. “Light and sunshine are healthy and help redirect the brain.”
Kriseman had a retired doctor client who refused to take his medications in a skilled nursing residence. She had staff members create a chart, listing his medications so he could check them off when taken. That technique worked because the activity was meaningful to him as a physician.
Keep conversations simple and direct. For example, if the person resists bathing, instead of saying, ‘I need you to come to the bathroom so you can take a bath and shave and I can wash your hair,’ a simple ‘Dad, we’re going to the bathroom’ is easier to comprehend. “Only ask for one thing at a time,” says Kriseman. “Keep it simple. They get lost in it all.”
If Mom won’t eat and says she’s not hungry, you don’t have to push. Instead, try a “bridge phrase” that moves the conversation to a different place. For example, you can tell Mom how much you always loved her fried chicken and ask her if she remembers how the house used to smell while it cooked or how she prepared the meal. Then a little later, maybe return with “Hey, how about we both have a bite of this sandwich?”
Not everyone with dementia feels comforted by touch. However, if the person is okay with it, touching that person’s arm or shoulder or gently holding their hand can be comforting and grounding.
With redirection, keep in mind that one technique may work fine one time but not the next, so it’s a good idea to have several options on hand.
“The whole idea of redirection is that you want the person to feel cared about and listened to and make sure they’re in a safe situation,” says Kriseman.
Are you a family caregiver who has more suggestions on how to redirect a loved one with dementia? We’d like to hear your tips in the comments below.
Deb Hipp is a freelance writer in Kansas City, Missouri, who specializes in caregiving, aging and senior living.